Puerperal Diseases of the Utems 58 



fected. The operator should trim his finger nails closely 

 and smoothly and disinfect and soften his hands in a warm 

 disinfecting solution. The disinfectant may then be rinsed 

 off the hand with warm water and the capsule, inclosed 

 within the hand, carried deeply into the sac of the fetal 

 membranes and dropped there. 



A method which is certainly more efficient in many, and 

 possibly in most cases is the introduction of the iodoform or 

 other drug suspended in a neutral oil. Liquid paraffin is 

 probably in all respects the preferable medium. The drug is 

 to be placed in a pint or quart bottle, the vessel filled with 

 the oil, and then shaken until well suspended. It is then to 

 be poured into a hospital irrigator with the seven-foot rub- 

 ber catheter designed for douching bulls attached, the end 

 of the catheter carried by the hand and held as deeply within 

 the cavity as can be reached, the irrigator elevated two or 

 three feet above the uterus, and the contents allowed to flow 

 in. The heavy drug falls down upon the floor of the uterus, 

 as with the capsule, while the oil floats upon other liquids 

 which may be present and comes in contact with and soothes 

 any portions of the inflamed genital mucosa which may be 

 uncovered. It is more trouble to prepare and apply, and 

 the average layman is more liable to make some mistake in 

 the handling of the iodoform and taint the milk from cows 

 other than the one diseased. 



The plan just described should also occupy a large place in 

 the handling of retained fetal membranes by the skilled vet- 

 erinarian. In all those cases where at the time of examina- 

 tion it is not feasible to remove the membranes manually, 

 the iodoform capsule or the introduction of an iodoform sus- 

 pension in oil or liquid paraffin constitutes the best line of 

 treatment at present known. 



In practice one occasionally encounters retained placenta 

 in which the underlying metritis is of a highly irritable type 

 and the cow evinces much pain by constant and violent 

 straining. In rare cases this is due to intussusception of the 

 ovarian end of the gravid horn, which may eventually end 

 in uterine prolapse, or may telescope for a few inches, be- 



